Analysis of the recourse to conservative surgery in the treatment of breast tumors
| Autor: | Piero Borgia, Marina Scarinci, Carlo A. Perucci, Patrizia Schifano |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Adult
Cancer Research medicine.medical_specialty Multivariate analysis Databases Factual Breast surgery medicine.medical_treatment Breast Neoplasms Cancer Care Facilities Logistic regression Mastectomy Segmental Severity of Illness Index 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Breast cancer Severity of illness Medicine Humans Aged Neoplasm Staging Retrospective Studies business.industry Patient Selection Age Factors Cancer Retrospective cohort study General Medicine Length of Stay Middle Aged medicine.disease Surgery Oncology Italy Social Class 030220 oncology & carcinogenesis Practice Guidelines as Topic Female Guideline Adherence business |
| Zdroj: | Scopus-Elsevier |
| ISSN: | 0300-8916 |
| Popis: | Aims and Background Conservative surgery is the treatment of choice for malignant tumors, at least up to stage II. The aim of this study was to analyze the recourse to conservative surgery for breast tumors and its determinants (ie, characteristics of hospitals and patients). Methods The study was conducted in Italy's Lazio region and was based on administrative data of the regional Hospital Information System, a database on hospitalizations. We selected all regional hospitalizations for therapeutic breast surgery over 1997, classifying them as either “conservative” or “non-conservative”. The other variables considered were type of hospital, number of beds, volume of activity (average annual number of hospitalizations for breast cancer surgery), specific diagnosis, severity of cancer, and patient's age, place of residence, and socioeconomic level. A logistic model was used for multivariate analysis. Results A total of 7235 hospitalizations were analyzed, 3570 (49%) for malignant tumors and 3665 (51%) for benign disease. The logistic model showed that the factors most closely correlated with conservative surgery were age (OR = 2.2; 95% Cl: 1.8-2.6, for the age group 70 years); severity of cancer (OR = 0.6; 95% Cl: 0.5-0.8, for non-localized compared to localized tumors), and volume of activity of the hospital (OR = 1.3; 95% Cl: 1.0-1.6, for hospitals with >70 operations/year compared to those with Conclusions The association between conservative surgery and younger age, even after controlling for the severity of cancer, points to the need to encourage adherence to the existing guidelines. The association between conservative surgery and high-volume hospitals and the finding that a high proportion of breast operations is performed in low-volume facilities suggest that further efforts should be made to promote admission to high-volume hospitals. |
| Databáze: | OpenAIRE |
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